Vaccines do not cause autism, says Dad who should know [Opinion]

Dr. Peter Hotez, president of the Sabin Vaccine Institute and founding dean of the School of Tropical Medicine at Baylor College of Medicine, poses for a portrait in the institute's lab Wednesday, April 11, 2012, in Houston. Dr. Hotez is a U.S. science envoy. (AP Photo/Houston Chronicle, Brett Coomer)

Photo: Brett Coomer, MBI / Associated Press

The anti-vaccine movement, especially in the United States and Europe, has been mostly successful in spite of the overwhelming evidence that vaccines do not cause autism, and in the face of overwhelming evidence for the genetic and epigenetic bases of Autism Spectrum Disorder. Indeed, the anti-vaccine lobby has managed to persuade a generation of parents to opt their kids out of vaccinations despite the fact that they prevent the world’s most dangerous childhood infections that kill hundreds of thousands of children annually. In its place the anti-vaxxers promote a narrative that has no scientific basis, nor even plausibility, while directly threatening the health and well-being of children. How did we allow things to get to this point?

In some countries, such as Pakistan or Afghanistan, anti-vaccine activities are driven by fear and ignorance fostered by the Taliban, which is intent on maintaining political dominance in a part of Central Asia at all costs, including the health of its children. It’s disgusting and awful, but at some level we can begin to understand their political motives. In contrast, so far I’m not sure I truly understand the self-destructive motivations of the American anti-vaccine movement. It is a movement intent on placing America’s children in harm’s way for the sake of an ideology totally devoid of benefit.

In several of the 18 states that currently allow vaccine exemptions for nonmedical or philosophical reasons, the numbers of exemptions are rising dramatically. In the case of Texas, where there has been almost a 20-fold increase over the past decade, I attribute the rise to the fact that the anti-vaccine movement has been extremely well organized. Through both the movie Vaxxed: From Cover-Up to Catastrophe, and the rallies, marches, and lobbying activities of the political action committee, Texans for Vaccine Choice, a story has been concocted that is extremely compelling. The anti-vaccine lobby has made effective use of Twitter and other social media outlets.

Unfortunately, the Texas story, although compelling and convincing to those without a scientific background, also has no basis in reality. Instead it is a collection of fake news, half- truths, and conspiracy theories, which have been cleverly strung together to create a faux narrative. So how did it come to pass that such pseudoscience has been palmed off on the population of Texas, as well as many of the other 17 states that currently allow nonmedical vaccine exemptions?

Blaming others

There’s certainly no shortage of blame to go around. Vaccine policy is regulated at the state level, so that means there are 18 state legislatures that for some reason have remained susceptible and vulnerable to the misinformation put out by the anti-vaccine communities. But the anti-vaccine movement, especially in the United States, also has had a lot of help and from some unexpected sources. Certainly the media, even the mainstream media, has had an important role in perpetuating myths about vaccines and autism. On multiple major news outlets, including CNN, Fox News, MSNBC and the major networks, I hear over and over again about the vaccine-autism “controversy,” as though there really is a controversy about whether vaccines cause autism. By the way, they don’t! To this day, most major television news outlets use almost every story I have ever seen about vaccine and autism to keep the door open about potential links and plausibility. They seldom pass up an opportunity to give a voice to prominent individuals with strong anti-vaccine views.

Unfortunately, another and perhaps bigger problem, from my perspective, is the U.S. government , which has been mostly silent about the rise in nonmedical exemptions and the dangers of not vaccinating children. So while I have not heard any U.S. official actively promote anti-vaccine viewpoints, the leadership of the CDC, U.S. Public Health Service, Department of Health and Human Services, U.S. National Institutes of Health and the White House have nevertheless made few, if any, public statements refuting the Vaxxed movie or other incorrect assertions from the anti-vaccine community. It’s also important to point out that the silence from the Surgeon General, DHHS, CDC and White House cuts across the presidential tenure of both major parties. Yes, this is a problem in the Trump administration, but it was also true for the Obama, Bush and Clinton administrations. I’ve been told that some of this government silence may be deliberate — that perhaps our officials don’t want to provide undue attention to the anti-vaccine movement because they believe it’s a fringe movement that will eventually go away. I think it’s pretty clear that the anti-vaccine movement has since taken advantage of the silence and the vacuum to become well-funded and organized. I also believe that many Americans have come to believe that the American government’s silence on this issue is somehow a tacit endorsement of anti-vaccine views.

An important reason for urging the media, state governments, and federal agencies to speak out in behalf of vaccines, while refuting the anti-vaccine community, is that they could make an important difference in convincing parents to vaccinate. From my experience, the majority of parents who choose to not vaccinate their kids are not actually deeply entrenched in their opposition. Instead, they have read something unsavory about vaccines on the Internet from one of the anti-vaccine websites, or they have been told something bad about vaccines by friends or relatives. For those parents, I have found that if you take the time to explain to them why vaccines are necessary and why they don’t cause autism, or why their anti-vaccine neighbor, friend, spouse, boyfriend, or girlfriend is pushing misinformation, they begin to understand and agree to vaccinations.

However, I have also found that another 10-20 percent of parents harboring anti-vaccine views are indeed deeply dug in and have incorporated this mindset into their personal belief system, or even into their personal identity. In my experience, it’s really tough, if not impossible, to reach those parents.

Blaming ourselves

In the end, I also blame us, meaning myself and the scientific community. I believe that we have been too reluctant to engage the public in a meaningful way in order to fight and counteract the false and misleading statements made on social media and the Internet, public rallies, and phony summits and documentaries.

According to the Pew Research Center in a study conducted in association with the American Association for the Advancement of Science (AAAS), as a profession, American scientists are not performing well in terms of public engagement. Their study found that while scientists support active engagement in public policy discussion in overwhelming numbers, the scientists themselves are not out there in the public eye.

I believe that the precipitous rise of the anti-vaccine movement has been enabled by a vacuum in public engagement by scientists. We’re too focused on our grants and papers and have not allowed ourselves to devote time to public lectures, social media, blogs, print and electronic interviews, and other forms of public outreach. Similar reasons may also underlie the collapse of public support for aggressively addressing climate change and other timely scientific issues.

PLOS and the New York Times

In addition to heading a tropical medicine school and vaccine institute in Texas, I also serve as founding editor in chief of PLOS Neglected Tropical Diseases, the first open access journal for tropical medicine. The open access concept was developed in the early twenty-first century and led to the forma tion of PLOS, which stands for the Public Library of Science. Essentially, anyone with a computer and Internet connection can download PLOS articles without worrying about a paywall that currently blocks access to most of the papers published in prestigious journals such as the New England Journal of Medicine, JAMA (Journal of the American Medical Association) and the Lancet. Today there are several prominent families of open access journals, including PLOS, BioMed Central and eLife, among others. In addition, Nature, Science and other traditional science publishers have now created new open access spin-off journals. This is an important trend that is revolutionizing science publishing and making important biomedical literature available to scientists across the planet.

Late in 2016, I began writing a series of articles, initially in one of our allied PLOS journals, PLOS Medicine, which in some ways represents the open access equivalent to high-profile general medical journals; and later in PLOS Speaking of Medicine, one of the best-known PLOS blog sites. The point of the articles was to warn about the events unfolding in Texas but also to assemble much of the salient literature justifying my assertions that vaccines did not cause autism.

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But nothing prepared me for the firestorm that resulted when I wrote an op-ed piece for the New York Times on Feb. 8, 2017, titled “How the Anti-Vaxxers Are Winning.” The piece had effects that were both good and bad. On the positive side, it alerted the general public to the anti-vaccine calamity brewing in Texas and the risk of it becoming nationwide. It highlighted an imminent measles risk to Texas and elsewhere in the United States, such as what then happened in Minnesota. It also succinctly summarized my evidence that vaccines do not cause autism and why it’s not even plausible that vaccines cause autism. The article also attempted to de-bunk the Vaxxed movie and faux CDC conspiracies. In short, the Times piece provided a national and global stage to counteract the rising U.S. anti-vaccine movement.

But there was also a dark side to how my op-ed was received.

Specifically, almost immediately after the op-ed was published I was subjected to a string of accusations from the anti-vaccine communities. Many of them alleged that I had become either a shill for industry or that I was making millions of dollars from my vaccines for neglected tropical diseases. The attacks also included a YouTube video alleging I was exaggerating the adverse health effects of measles, calling me “The Boy Who Cried Wolf,” and some strange tirade pointing out that by living in a sanctuary city I was attempting to deliberately import measles into the United States in order to ignite an epidemic. In the end, the anti-vaccine communities faced a hard time making any accusation stick or sound credible. Although I wasn’t exactly Teflon, one prominent anti-vaccine spokesperson actually issued a retraction and apology of sorts after I confronted him about his public statements.

Will the New York Times piece become an effective stop- gap to halt or slow what I have termed an American neo-anti-vaccine movement? Probably not, but my goal in writing it was to become a prominent voice that could provide a reasonable alternative narrative for the autism parent community. My major message was that vaccines are safe and do not cause autism.

Excerpt from Vaccines Did Not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism Dad’’ by Dr. Peter Hotez. Copyright 2018. Used with permission of Johns Hopkins University Press.